Hazards of pentazocine for neonatal analgesia: a single-centre experience over 10 years.

MedLine Citation:

PMID:
18727849
Owner:
NLM
Status:
MEDLINE

Abstract/OtherAbstract:

BACKGROUND: In developing countries, neonatal analgesia for surgical procedures is a major challenge where postoperative care is inadequate. AIM: To report experience of pentazocine for neonatal surgery in a Nigerian tertiary hospital. METHODS: A retrospective study of surgical neonates who received pentazocine at the University of Benin Teaching Hospital in Benin City between January 1998 and December 2007. RESULTS: During the period, 2590 paediatric operations were performed including 368 (14.2%) neonates, 49 (13.3%) of whom had pentazocine. The other neonates received a variety of analgesics. Of 56 neonates who developed respiratory depression, 40 (71.4%) had pentazocine (p<0.0001). Fifteen (30.6%) neonates aged between 9 hours and 28 days [mean (SD) 12 (1.2) days] died between 1 and 36 hours following 8-hourly administration of 0.5 mg/kg pentazocine. In older children who had pentazocine, over-sedation was also a problem but there were no deaths. Deaths in neonates were mainly owing to persistent respiratory depression which was compounded by the unavailability of a paediatric ventilator. However, many neonates responded to naloxone. All neonates who died had an autopsy and no lesion was found which could have compromised respiratory function. CONCLUSION: The use of pentazocine in neonates was associated with high morbidity and mortality. Caution is required when using pentazocine for neonatal analgesia where post-operative respiratory support is insufficient.